In order to find out whether organizational characteristics and professional attitudes are positive predictors of the job satisfaction of physicians, an analysis is presented, based on a survey of 121 internists in 13 medical departments in Dutch university hospitals. The study indicates that formal structuring of work activities is a positive predictor of work environment satisfaction, whereas size is a negative predictor. Professional attitudes such as service orientation and craftsmanship are strong positive predictors of satisfaction with patient demand. The study also indicates that certification (being a medical specialist or not) positively relates to work load satisfaction.Controlling for certification reveals that the absence of a significant relationship between formal structuring of work activities and work load satisfaction is accounted for by a positive correlation for medical specialists and a negative one for residents in training to become specialists. This indicates the importance of a difference in hierarchical position for the relation between formal structuring of work activities and physician satisfaction. The results for hospital physicians are consistent with satisfaction studies in other settings: dependency on bureaucratic procedures is associated with dissatisfaction, while the advantages of bureaucracy — the possibility of creating routines and procedures to limit role ambiguity — are conducive to satisfaction.